For a small group of nonhospitalized patients with coronavirus disease 2019 (COVID-19), self-administration of high-dose oral famotidine was found to be associated with improvements in disease-related symptoms, according to a recently published case series.
Famotidine, an over-the-counter histamine H2 receptor antagonist, was recently identified as a potential therapy for COVID-19 based on findings from a retrospective cohort study that included hospitalized patients. In this case series, longitudinal changes in patient reported outcome measures were quantitatively assessed in 10 COVID-19 patients who self-administered famotidine as outpatients.
Questionnaires and telephone interviews were used to obtain information on patient demographics, COVID-19 diagnosis, use of famotidine, drug-related adverse events, temperature measurements, oxygen saturation values, and symptoms scores.
“Based on a National Institute of Health (NIH)-endorsed Protocol to research Patient Experience of COVID-19, we collected longitudinal severity scores of 5 symptoms (cough, shortness of breath, fatigue, headaches and anosmia) and general unwellness on a 4-point ordinal scale modelled on performance status scoring,” the authors explained. Statistical comparisons were made between longitudinal combined normalized symptom scores.
The analysis included 10 consecutive COVID-19 patients with diverse demographics and various risk factors associated with disease severity. The most common dose of famotidine self-administered was 80mg three times daily (n=6) for a median of 11 days (range: 5-21 days).
Findings of the analysis revealed that treatment with famotidine was both well tolerated and beneficial, with rapid improvements noted within 24 to 48 hours after starting the drug. “In addition, for all patients who were able to provide data, temperature readings, oxygen saturations and activity improved in correlation with taking famotidine,” the authors stated.
Moreover, symptoms continued to improve to close to pre-illness levels 14 days after the first dose was administered. The study patients reported that airwary-related symptoms (ie, cough, shortness of breath) improved faster than systemic symptoms (ie, fatigue) while taking famotidine.
“Our case series suggests, but does not establish, a benefit from famotidine treatment in outpatients with COVID-19,” the authors concluded. They added, “Future work will investigate potential mechanisms of action and clinical relevance of famotidine.”
Janowitz T, Gablenz E, Pattinson D, et al. Famotidine use and quantitative symptom tracking for COVID-19 in non-hospitalised patients: a case series [published online June 4, 2020]. Gut. doi: 10.1136/gutjnl-2020-321852.